"Consider the Kids": The Effectiveness of a Fetal Effect Educational Video on Pregnant Women's Knowledge and Self-Efficacy Related to Tobacco Use
Abstract (summary)
Background: Maternal smoking during pregnancy is a predictor of several adverse fetal outcomes; yet prevalence remains high in the Twin Tiers of New York and Pennsylvania.
Purpose: Study tested effectiveness of the “ConSIDer the Kids” video in a double-blind randomized control design integrated into routine prenatal care. Two-fold study objectives: 1) test the video’s impact which highlights fetal effects of prenatal smoking on pregnant women’s knowledge and self-efficacy, 2) examine associations of pregnant women’s demographic characteristics among smoking status, knowledge and self-efficacy.
Methods: Pregnant women (N = 89), regardless of smoking status at their first prenatal visit, were recruited from four obstetric offices in NY and PA, then randomly assigned to control (generic pregnancy nutrition video) (n = 46) or experimental (“ConSIDer the Kids” video) (n = 43) groups. The 24-item Perinatal-Tobacco Attitudes and Behaviors Survey (P-TABS) measured demographic characteristics, smoking status, knowledge and self-efficacy pre- and post-intervention. Nurses administered the P-TABS survey and videos via iPad. The sample: pregnant women with a mean age of 27.6 (SD 4.9); 46.1% reported smoking in the last year; 77.5% were cohabitating; 38.2% were primigravidas and 60.7% reported highest education as high school.
Results: Study found a significant increase in total fetal effects knowledge in the experimental group (entire sample as well as smoker subgroup) compared to the control group (p = .001, p = .035). However, despite an increase in knowledge of fetal negative effects for the experimental pregnant smoker subgroup, the only significant increase was for ADHD. No significant increases in self-efficacy for pregnant smokers were reported in the experimental group. Marital status, gravidity and parity were not significantly correlated to knowledge scores. Higher education was associated with increased knowledge for fetal effects as well as higher self-efficacy. Pregnant smokers reporting lower self-efficacy had significantly higher gravidity, parity, tobacco dependence, less intention and family support to quit.
Conclusion: Findings demonstrate a brief educational video about tobacco use fetal effects increases maternal knowledge. Additional research is needed to follow women throughout pregnancy and verify self-report with cotinine assays to study the video’s impact on smoking cessation behaviors.